Precertification Specialist - Remote and/or Hybrid

CONSULTANTS IN GASTROENTEROLOGY

4d • Hybrid

About The Position

Job DetailsJob Location: CIG WEST COLUMBIA - WEST COLUMBIA, SC 29169Position Type: Full TimeJob Shift: DayJob Category: General BusinessJob Duties Review patient medical records and insurance policies to determine the need for prior authorization Submit and track prior authorization requests to ensure timely approvals Submit necessary clinical documentation to insurance carriers to obtain prior approval for procedures and tests Resolve authorization denials, communicating issues with provider, patient, and appropriate staff Answering incoming phone calls related to precertification from patients or insurance companies Work with area medical centers to ensure appropriate authorizations are done Stay up to date with insurance policies that would impact prior authorizations Requirements 1-3 years of experience in medical prior authorization/precertification Proficiency with insurance portals Ability to review medical records and insurance information accurately QualificationsRequirements 1-3 years of experience in medical prior authorization/precertification Proficiency with insurance portals Ability to review medical records and insurance information accurately

Requirements

• 1-3 years of experience in medical prior authorization/precertification
• Proficiency with insurance portals
• Ability to review medical records and insurance information accurately

Responsibilities

• Review patient medical records and insurance policies to determine the need for prior authorization
• Submit and track prior authorization requests to ensure timely approvals
• Submit necessary clinical documentation to insurance carriers to obtain prior approval for procedures and tests
• Resolve authorization denials, communicating issues with provider, patient, and appropriate staff
• Answering incoming phone calls related to precertification from patients or insurance companies
• Work with area medical centers to ensure appropriate authorizations are done
• Stay up to date with insurance policies that would impact prior authorizations

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed